Bulletin Analysis The national reporting completeness for Week 4 reached 97.6%, representing a notable improvement from previous weeks. This high level of reporting across the One Health Surveillance Platform (OHSP) indicates that facility-level data entry is becoming more consistent. Most districts have achieved the 100% threshold, ensuring that the epidemiological data is representative of the entire population. Maintaining this momentum is crucial for effective health resource planning and early outbreak detection. However, there are still minor gaps that need addressing to reach absolute completeness nationwide. Zonal Epidemiology Officers are urged to continue their support to facilities that face persistent connectivity or staffing challenges. Consistent reporting at this level provides the solid evidence base needed for national public health decision-making.

Bulletin Analysis Timeliness of reporting for Week 4 stands at 94.6%, showing a significant positive trend in the speed of data submission. While this is an excellent achievement, specific districts including Balaka, Karonga, Mzimba South, and Machinga DHOs have been flagged for needing improvement. Timely data is the lifeblood of the IDSR system, as even a 24-hour delay can impact the speed of a life-saving response. We continue to emphasize that data should be validated and verified by IDSR coordinators as soon as it is entered into the system. Addressing the bottlenecks in these lagging districts remains a priority for the National IDSR Secretariat. Improved timeliness ensures that alerts are acted upon while they are still manageable at a local level. Sustained technical support will be provided to ensure all districts meet the 100% timeliness target consistently.

Bulletin Analysis A total of 18 Event-Based Surveillance (EBS) signals were reported during this week, underscoring the vigilance of community and facility-level actors. These signals represent unusual health events that require rapid verification to determine their public health significance. It is mandatory that District Rapid Response Teams (DRRTs) conduct thorough risk assessments for all 18 verified signals without any further delay. Community engagement remains the primary driver of these signals, and maintaining trust with local leaders is essential for ongoing detection. The variety of signals reported this week highlights the broad spectrum of health threats being monitored beyond routine diseases. We encourage all districts to continue refining their signal detection mechanisms to capture potential outbreaks at their earliest stages. Timely assessment of these events is critical to prevent small clusters from escalating into widespread emergencies.

Bulletin Analysis Malaria remains the most significant burden on the health system, with 51,408 cases and 8 reported deaths during Week 4. This high case volume during the peak transmission season requires vigilant case management and consistent supplies of RDTs and ACTs. While the case count is slightly lower than previous weeks, the increase in mortality highlights the need for early diagnosis. Health facilities must prioritize severe malaria cases for immediate inpatient care to reduce the risk of further fatalities. Community health workers are encouraged to intensify their efforts in promoting the use of long-lasting insecticidal nets (LLINs). We are closely monitoring districts with rising case fatality rates to identify gaps in clinical management protocols. Strengthening the supply chain for antimalarial commodities is essential to ensure no facility runs out during this critical period.

Bulletin Analysis Surveillance for bloody diarrhoea recorded 1,279 cases this week, indicating a persistent risk of enteric infections across the country. This condition is a sensitive indicator for potential outbreaks of shigellosis or other serious pathogens linked to poor hygiene. All reported cases should be investigated to identify potential environmental contamination sources, particularly during the rainy season. Strengthening water, sanitation, and hygiene (WASH) interventions in the most affected districts is a top priority. Clinicians are reminded to strictly follow the diagnostic and treatment algorithms for dysentery to ensure appropriate antibiotic use. Laboratory confirmation of a subset of these cases is necessary to monitor for any emerging patterns of antimicrobial resistance. The rise in cases compared to earlier weeks necessitates intensified community education on food safety and handwashing.

Bulletin Analysis Typhoid fever surveillance recorded 36 cases this week, showing a decrease compared to the mid-January spike but requiring continued monitoring. Typhoid transmission is often localized, making it essential to conduct environmental audits in areas where clusters of cases appear. Ensuring access to safe drinking water and promoting household water treatment remain the most effective prevention strategies. Public health officials should collaborate with water boards to address any infrastructure failures contributing to contaminated supplies. Clinical staff should maintain awareness that typhoid can mimic other febrile illnesses, including malaria, making lab verification vital. We are analyzing the geographic distribution of these cases to target high-risk zones for specific hygiene interventions. Long-term reduction of typhoid depends on sustained investment in sanitation and the potential introduction of typhoid conjugate vaccines.

Bulletin Analysis A concerning 7 maternal deaths were reported during Week 4, necessitating immediate and rigorous investigation by the Reproductive Health Department. Each of these deaths must undergo a Maternal Death Surveillance and Response (MDSR) audit within 24 to 48 hours. These audits are critical for uncovering the “three delays”: delay in seeking care, delay in reaching a facility, and delay in receiving adequate care. Identifying the root causes of these deaths is essential for implementing corrective measures to prevent future occurrences. We must ensure that all facilities are equipped with basic and comprehensive emergency obstetric care capabilities. Strengthening the referral system for high-risk pregnancies remains a cornerstone of our strategy to lower maternal mortality. Every maternal death is a sentinel event that indicates a need for systemic improvement in maternal healthcare services.

Bulletin Analysis There were 83 cases of Severe Acute Respiratory Infection (SARI) reported this week, with 1 confirmed death. SARI surveillance is vital for monitoring the circulation of respiratory pathogens, including seasonal influenza and COVID-19. Clinicians should be particularly vigilant in identifying respiratory distress in pediatric and elderly populations who are at higher risk. Early clinical intervention, including oxygen support and appropriate antibiotics for secondary infections, is key to reducing mortality. We are currently analyzing viral samples from SARI cases to detect any shifts in circulating strains or potential new threats. Infection prevention and control (IPC) measures in hospitals must be strictly enforced to prevent nosocomial transmission of respiratory viruses. Continued public messaging on respiratory hygiene is necessary to mitigate the spread within the community.

Bulletin Analysis A total of 103 Adverse Events Following Immunization (AEFI) were reported, which reflects the high activity level of our national immunization programs. The vast majority of these cases represent minor, non-serious reactions that are typical of standard vaccines. This high reporting rate is actually a positive indicator of a sensitive and transparent safety monitoring system. It demonstrates that health workers are committed to the careful follow-up of all vaccinated individuals and are documenting all reactions. Maintaining this level of surveillance is essential for building and sustaining public trust in vaccine safety across all age groups. Any serious or unusual AEFIs are immediately referred to the National AEFI Committee for expert investigation. This rigorous approach ensures that the benefits of immunization continue to far outweigh any risks.

Bulletin Analysis For Week 4, there were zero new confirmed cases of Mpox, but the surveillance system generated 7 new alerts. This indicates that clinicians and community members remain on high alert for symptoms such as unexplained rashes or lesions. Rapid verification and laboratory testing of these alerts are essential to ensure any potential introduction of the virus is caught early. We continue to monitor the regional situation closely, as the threat of cross-border transmission remains significant. Health workers must maintain high standards of IPC when managing suspected cases to protect themselves and other patients. Public awareness efforts should focus on encouraging individuals with suspicious symptoms to report to the nearest health facility immediately. This proactive stance is our best defense against a potential Mpox outbreak within our borders.

Bulletin Analysis Six cases of Acute Flaccid Paralysis (AFP) were reported this week, highlighting the critical importance of our ongoing Polio surveillance. Each AFP case must be investigated within 48 hours, and two stool samples must be collected to rule out poliovirus. Additionally, 5 cases of Meningococcal meningitis were recorded, which requires immediate clinical action and contact tracing. Meningitis is a medical emergency that demands rapid diagnosis through lumbar puncture and the initiation of life-saving antibiotics. We are monitoring these cases to identify any potential clusters that could indicate a localized outbreak. Ensuring that our laboratory systems can quickly identify the specific strain of meningitis is vital for guiding the public health response. High routine immunization coverage remains the most effective long-term protection against both of these serious conditions.

Bulletin Analysis Measles surveillance and cholera containment remain high-priority areas as we move through the first quarter of 2026. Measles clusters are being closely monitored, with a focus on districts that have historically shown lower immunization coverage. Achieving and maintaining 95% coverage with two doses of the Measles-Rubella (MR) vaccine is essential for herd immunity. Regarding cholera, although cases have fluctuated, the risk remains high in districts with poor sanitation and during periods of heavy rainfall. Multi-sectoral collaboration between health, water, and local government is the only way to effectively contain cholera outbreaks. Reactive vaccination campaigns and the strengthening of oral rehydration points are key components of our current response strategy. We urge all partners to continue supporting these critical interventions to protect the most vulnerable populations from these preventable diseases.